A Time for Reflection, Part I of III

Like everyone, I have been rocked to my core by the recent massacre of 20 small children and seven adults in Newtown, Connecticut.  My first thoughts were of my children and my grandchildren, and trying to imagine a world with one of them ripped so violently away.  This attack defies logic and reason, and we may never truly know what motivated the killer to do what he did.

As we can’t really comprehend why, then we can only speculate as to how to prevent such a horrific tragedy from happening again.  It seems to me that three things really need to be addressed:  Access to mental health services, gun ownership, and our society’s addiction to violence.  Any one of these three issues can make for one overwhelming conversation, and I don’t claim to have any easy answers, but I'd like to try to address it.

This is the first of three installments on this subject.  This first post is about mental health services.  The second post will be about gun ownership, and the third will be about society's addiction to violence.

According to sources I have read, the shooter had a history of emotional and behavioral troubles; his mother had attempted to get mental health care for him, and was basically told it wasn’t available until he “did something bad.”  This is a common theme in our society, and I believe there are two reasons for this: 

One reason is that programs serving the mentally ill, and other marginalized populations, have been drastically cut.  This leaves providers the unpleasant task of putting out fires, rather than providing early intervention for at-risk kids.  It also seems to create a tendency to “throw pills” at the problem, which certainly creates a big risk of its own, since a common side effect of some of these pharmaceuticals is irrational, violent, or suicidal behavior.  It's a lot less effort to fill out a prescription pad than to strategize effectively with parents on techniques that might help the child.  And sedated kids are a lot less effort for teachers and caregivers than hyper/troublesome kids.  Certainly an entire blog post could be easily written on the corruption of the pharmaceutical industry alone, and its collusion in causing violence. 

The other reason that people often can’t/don't access help, besides the obvious financial one, is overly restrictive involuntary commitment laws.  These laws, which were set up to protect people from being wrongly committed to institutions, has some negative unintended consequences.  Anosognosia, a physiologically-caused lack of awareness about one’s illness, prevents approximately half of severely mentally ill people from taking their meds or seeking treatment.  Many are unlikely to get help unless others step in, in the form of attempting an involuntary commitment.  In Oregon, that means that at least two family members have to sign a sanity hearing petition, which results in a court hearing to review whether or not that person should be committed.  It has to be proven that the person in question is a danger to himself/others, or can’t meet his own needs, at least in Oregon.  It is not enough for that person to have bizarre behavior, be vulnerable and living in a box under an overpass, or in danger.  It usually means “something bad” has to happen. 

The Treatment Advocacy Center is a national non-profit dedicated to eliminating barriers to treatment for those with mental illness.  

According to their website, Connecticut has an estimated 140,000 people with severe mental illness, of whom approximately one-half are untreated at any given time. It is one of only six states without a law authorizing court-ordered outpatient treatment for qualifying individuals with severe mental illness. Between 2005 and 2010, the state eliminated 17% of its public hospital beds, leaving it with only 43% of the number deemed minimally adequate to meet public needs, and has twice as many people with severe mental illness behind bars as in psychiatric hospital beds. 

If the young shooter had received mental health care, would those 20 children be alive today?  Perhaps.  It certainly is an important factor, as the majority of these mass killers seem to share a profile of long-standing, and often untreated, mental instability.  This should be an intense part of our current national discussion.  If we truly care about the safety of our children, and the overall health of our population, we MUST start finding ways to fund, and make accessible, better mental health care. 

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